Andrew Conrad Rucker

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP9899 Issued in AZ

Practice address

3269 N Stockton Hill Rd
Kingman, AZ 86409-3619

Phone

(928) 757-2101

NPI assigned

Jan 14, 2017

Last updated

Feb 8, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Innova Emergency Medical Associates PCGroup PAC ID 2860633435, 69 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Innova Emergency Medical Associates PC

  • Emergency Medicine Physician
  • Trinidad, CO
  • NPI 1295178978

  AZ

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486512000000",
    "number": "1083150015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3269 N STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093619",
            "telephone_number": "928-757-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3269 N STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093619",
            "telephone_number": "928-757-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "ANDREW",
        "middle_name": "CONRAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-14",
        "last_updated": "2017-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP9899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Route 66 Cab Inc
• Route 66 Cab Inc.
• Anthony Edmond Rowden, NP
• Bradley Norman Rowden, NP-C
• Maya Royce
• Tiffany E Russell, MD
• S Ismail Bokhari, M.D., P.C.
• S Ismail Bokhari, M.D., P.C.
• S Ismail Bokhari, M.D., P.C.
• S Ismail Bokhari, MD, PC

• Family Nurse Practitioner in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.